Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
RL-A-EBV M 50240
Phoenix, AZ
See all hospitals reporting CPT 86665 →Price type
Dignity Health’s median price of $20 is 33% below the median hospital's median price ($30), higher than 32% of the 2,647 hospitals reporting CPT 86665. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 28 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare commercial|navigate fee schedule · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 2 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $11 | $11 | — | — | 3–30 | $11 – $11 |
| 3 | UnitedHealthcare commercial|options ppo fee schedule · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 4 | Aetna medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 5 | Blue Cross Blue Shield medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 6 | Cigna medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 7 | First Health medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 8 | Humana medicare|all plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 9 | Optum medicare|optumcare fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 10 | UnitedHealthcare medicare|all other plans fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 11 | UnitedHealthcare medicare|dual complete fee schedule · outpatient | $18 | $18 | — | — | — | $18 – $18 |
| 12 | UnitedHealthcare commercial|dignityhealthemployee fee schedule · outpatient | $20 | $18 | $3 | 18% | — | $14 – $21 |
| 13 | UnitedHealthcare medicaid|all plans fee schedule · outpatient | $19 | $19 | — | — | — | $19 – $19 |
| 14 | Optum medicare|optumhealth fee schedule · outpatient | $20 | $20 | — | — | 3–30 | $20 – $20 |
| 15 | Cigna commercial|exchange fee schedule · outpatient | $38 | $38 | — | — | — | $38 – $38 |
| 16 | Cigna commercial|localplus surefit fee schedule · outpatient | $40 | $40 | — | — | — | $40 – $40 |
| 17 | Optum commercial|optumhealth fee schedule · outpatient | $50 | $46 | $8 | 18% | — | $34 – $53 |
| 18 | Cigna commercial|all other plans fee schedule · outpatient | $53 | $53 | — | — | 3–30 | $53 – $53 |
| 19 | Cigna commercial|lifesource fee schedule · outpatient | $59 | $54 | $10 | 18% | — | $40 – $62 |
| 20 | Aetna commercial|all plans fee schedule · outpatient | $57 | $57 | — | — | — | $57 – $57 |
| 21 | Blue Cross Blue Shield commercial|maricopafocus fee schedule · outpatient | $63 | $63 | — | — | — | $63 – $63 |
| 22 | Blue Cross Blue Shield commercial|neighborhood fee schedule · outpatient | $63 | $63 | — | — | 3–30 | $63 – $63 |
| 23 | First Health commercial|all plans fee schedule · inpatient | $75 | $68 | $12 | 18% | — | $51 – $78 |
| 24 | First Health commercial|all plans fee schedule · outpatient | $75 | $68 | $12 | 18% | — | $51 – $78 |
| 25 | MultiPlan commercial|all plans fee schedule · inpatient | $85 | $77 | $14 | 18% | — | $58 – $88 |
Last updated: Feb 28, 2026
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